Great video, Khalid! I find it so interesting, that, even though manual therapy is a prescriptive process, carried out methodically and with great regard to the anatomy of the body, what is received by the patient is so, so subjective! I do feel that not everything has to 'work' in a quantifiable, scientific sense for it to benefit the patient.
That’s a really nice way of describing it Farhana! Thank you! You are right - there are so many things in physio which scientifically don’t always have the backing of evidence but can be useful - I suppose that is what makes it so interesting!
I love that you're making this series...and i have always had a similar view on healthcare as a physio and have always believed that patient education is poor in most of my patients, which i do think plays a role in their health outcomes...also great idea for a study at the end...i also tend to use some manual manouvers just to get the patient more relaxed and comfortable.
Well mulligan while being the least scientific school of manual therapy still it really proves that manual has more effect than only the neurophysiological one. You can clearly see it when you have immediate change in pain pushing towards 1 direction and huge difference when pushing towards another.
Hi Khalid, really looking forward to the rest of the series too. Touch and massage are all very subjective: some people don't feel like they've had a good massage unless they've been beaten up and others like the feeling of a more sensitive holistic approach. That's what I think you are trying to get across to us - manual therapists can't produce enough force to provide a tangible effect so it must be a psychological change. This seems to be the way in which the industry is shifting. On one CPD course I did recently one lady said her local chiropractor had recently hired a massage therapist and his appointments now consisted of him discussing pain with his patients for half an hour before sending them through for a relaxing massage for the remaining half hour. No adjustments at all. My limited understanding suggests that long term effects just aren't found from single infrequent adjustments. However I'm sure one of your previous videos (I think?) states that if you think your bad back will get better, it probably will. Power of the mind is definitely underestimated - giving it that nurturing stroke is needed. Especially post covid and in a world where any contact is questioned or demonised, touch now is very much forbidden and lacking. Is massage the human version of monkeys grooming each other? As I said: Looking forward to part 2 😄
Hey Grant! What a tremendous review! Thank you so much! Very interesting to hear from your course - I suppose this is one thing that the research from Geri et al may echo as well. I certainly will continue to see what evidence I can find about the effects and efficacy of manual therapy in terms of how much force can be applied etc…. I wonder if the video you mentioned is the acupuncture one, in that if you feel acupuncture will work for you, you are more likely to benefit from it……. Lots more to dive into!!!!
Ah this was such a neat video! Can’t wait to watch the others! The only thing that is when he said “Masseuse” we like the term Massage therapists if you’re licensed because there’s some states (Kansas comes to mind) that require no license or schooling while Nebraska requires 1000 hours and 180 hands on clinical hours
My English is not so good, but I will try to leave my comment on this subject. First, you could not be relaxed during the first period of your massage because the body simply can't relax when the pressure it's too high (big). The reason is, during big pressure on your soft tissue body can recognize that as a treat for yourself and that's why it's going in kinda protective mode (muscles get contracted and your brain don't know what to expect next) or simply you are not relaxed. Second, in Manual therapy you should never apply pressure to cause a pain to patient and like every other therapy screening it's very important. So if you know what you are doing, you can treat near and/or connected parts of the body without even touching painful areas. For example, if the patient comes with low back pain and you find out true screening that the lumbar part is over mobile. You can get really good results from one treatment just by mobilizing the thoracal part of the spine because it's under-mobile and relising Psoas. Manual therapy it's all about returning the body to homeostasis! Doesn't matter if you gonna do it by soft tissue release, decompression joints, mobilizing joints, or with just simple exercise. So I don't see how why you compare massage with manual therapy simply by touch?
Hi! Thank you so much for your response and it all makes sense.. I agree with you - massage and manual therapy generally are certainly different things. But I suppose the principle is that any manual therapy, like you said, with soft tissue mobilisation, with myofascial release , even with manipulations, the way we use our hands can still be used in a caring manner
Manual therapy is more than communication and relaxation. Myofascial release uses an outdated idea of what our hands can do, this is why I don't like it (and I don't even use massage in PT, except in neurodynamics and severe or extremely irritable patients) But accessory and physiological movements, MWM and such, this is what modern manual therapy should aim for. Manual therapists are more than "techniques", they are professionals that use a detailed subjective and objective examination to choose the correct passive/active treatment. They are able to record correctly on paper what they do with the patient, know how to test and re-test and assess to know correctly the outcome of their treatments. And, on top of that, they are good communicators, able to honest expression and simpatize with people. Manual therapy isn't "I treat you because I know things" Manual therapy is "I treat you because I know you"
Thank you so much for your message! I certainly agree that like so many therapists; professionalism needs to be spot on in terms of documentation and a thorough assessment … this is only the first video in this series, so there will still be lots more analysis to come!!
I like to combine manual therapy with pain neuroscience education and exercise. I've had many patients tell me that they enjoy working with me because i take a more manual approach. I have had to work hard to get away from the biomechanical explanations. I think one of the biggest problems with manual therapy is outdated explanations of what manual therapy can actually do.
Thanks Khalid, I have just got an MLS laser in the clinic, whilst the evidence for biostimulation is good, makes me wonder how much is the sympathetic touch. Laser therapy coming up with the Khalid laser look?
Hi Kalid; I would like to know if Neuromuscular Electrical Stimulation actually relieve pain? Some people tell me it works great, but it does nothing for me. The only thing that helps relieve my back pain is acupressure. A chiropractor explained to me that my tight muscles are the result of lactic acid build up through pinched nerves. To relieve the pain he would press very hard on the muscle(s) to force out the lactic acid. It seemed to work because I would be completely relieved of pain for a day or so. Is there any scientific basis for either of these treatments? Love your videos. Keep them coming.
You are starting to highlight the mechanism of change, rather than mere statistical analysis. It's more rigorous to ask 'how does X work ' rather than 'does X work (statistically) better than not X'
Great video, Khalid! I find it so interesting, that, even though manual therapy is a prescriptive process, carried out methodically and with great regard to the anatomy of the body, what is received by the patient is so, so subjective! I do feel that not everything has to 'work' in a quantifiable, scientific sense for it to benefit the patient.
That’s a really nice way of describing it Farhana! Thank you! You are right - there are so many things in physio which scientifically don’t always have the backing of evidence but can be useful - I suppose that is what makes it so interesting!
I love that you're making this series...and i have always had a similar view on healthcare as a physio and have always believed that patient education is poor in most of my patients, which i do think plays a role in their health outcomes...also great idea for a study at the end...i also tend to use some manual manouvers just to get the patient more relaxed and comfortable.
That’s a great idea of your own! Thank you so much for sharing and for your kind words!
Well mulligan while being the least scientific school of manual therapy still it really proves that manual has more effect than only the neurophysiological one. You can clearly see it when you have immediate change in pain pushing towards 1 direction and huge difference when pushing towards another.
Thank you so much!
Hi Khalid, really looking forward to the rest of the series too. Touch and massage are all very subjective: some people don't feel like they've had a good massage unless they've been beaten up and others like the feeling of a more sensitive holistic approach. That's what I think you are trying to get across to us - manual therapists can't produce enough force to provide a tangible effect so it must be a psychological change. This seems to be the way in which the industry is shifting. On one CPD course I did recently one lady said her local chiropractor had recently hired a massage therapist and his appointments now consisted of him discussing pain with his patients for half an hour before sending them through for a relaxing massage for the remaining half hour. No adjustments at all. My limited understanding suggests that long term effects just aren't found from single infrequent adjustments. However I'm sure one of your previous videos (I think?) states that if you think your bad back will get better, it probably will. Power of the mind is definitely underestimated - giving it that nurturing stroke is needed. Especially post covid and in a world where any contact is questioned or demonised, touch now is very much forbidden and lacking. Is massage the human version of monkeys grooming each other?
As I said: Looking forward to part 2 😄
Hey Grant! What a tremendous review! Thank you so much! Very interesting to hear from your course - I suppose this is one thing that the research from Geri et al may echo as well. I certainly will continue to see what evidence I can find about the effects and efficacy of manual therapy in terms of how much force can be applied etc…. I wonder if the video you mentioned is the acupuncture one, in that if you feel acupuncture will work for you, you are more likely to benefit from it……. Lots more to dive into!!!!
Ah this was such a neat video! Can’t wait to watch the others! The only thing that is when he said “Masseuse” we like the term Massage therapists if you’re licensed because there’s some states (Kansas comes to mind) that require no license or schooling while Nebraska requires 1000 hours and 180 hands on clinical hours
Wow that’s very interesting! Thank you so much for sharing 🙏🏼
My English is not so good, but I will try to leave my comment on this subject.
First, you could not be relaxed during the first period of your massage because the body simply can't relax when the pressure it's too high (big). The reason is, during big pressure on your soft tissue body can recognize that as a treat for yourself and that's why it's going in kinda protective mode (muscles get contracted and your brain don't know what to expect next) or simply you are not relaxed.
Second, in Manual therapy you should never apply pressure to cause a pain to patient and like every other therapy screening it's very important. So if you know what you are doing, you can treat near and/or connected parts of the body without even touching painful areas. For example, if the patient comes with low back pain and you find out true screening that the lumbar part is over mobile. You can get really good results from one treatment just by mobilizing the thoracal part of the spine because it's under-mobile and relising Psoas.
Manual therapy it's all about returning the body to homeostasis! Doesn't matter if you gonna do it by soft tissue release, decompression joints, mobilizing joints, or with just simple exercise. So I don't see how why you compare massage with manual therapy simply by touch?
Hi! Thank you so much for your response and it all makes sense..
I agree with you - massage and manual therapy generally are certainly different things. But I suppose the principle is that any manual therapy, like you said, with soft tissue mobilisation, with myofascial release , even with manipulations, the way we use our hands can still be used in a caring manner
So what is the difference between
manual therapy,
Osteo therapy,
Chiro therapy
Physio therapy.
Manual therapy is more than communication and relaxation. Myofascial release uses an outdated idea of what our hands can do, this is why I don't like it (and I don't even use massage in PT, except in neurodynamics and severe or extremely irritable patients)
But accessory and physiological movements, MWM and such, this is what modern manual therapy should aim for.
Manual therapists are more than "techniques", they are professionals that use a detailed subjective and objective examination to choose the correct passive/active treatment. They are able to record correctly on paper what they do with the patient, know how to test and re-test and assess to know correctly the outcome of their treatments. And, on top of that, they are good communicators, able to honest expression and simpatize with people.
Manual therapy isn't "I treat you because I know things"
Manual therapy is "I treat you because I know you"
Thank you so much for your message! I certainly agree that like so many therapists; professionalism needs to be spot on in terms of documentation and a thorough assessment … this is only the first video in this series, so there will still be lots more analysis to come!!
That is such a great comment... it's rare for UA-cam 😂
@@AbhayKumar-cm2kh 🙌🏼
I like to combine manual therapy with pain neuroscience education and exercise. I've had many patients tell me that they enjoy working with me because i take a more manual approach. I have had to work hard to get away from the biomechanical explanations. I think one of the biggest problems with manual therapy is outdated explanations of what manual therapy can actually do.
That’s a really great point!
Thank you Khalid. Likewise even we going to enjoy this series.
Thank you Rasika!
more blessed by your informative knowledge .Tons of thanks
Thank you so much Emmy!
Waiting for the next video of this series👍👍
Thank you!! 🙏🏼🙏🏼
Thanks mate amazing as always! I am. Looking forward for any f2f programme that we can attend
Thank you so much!
Thanks Khalid, I have just got an MLS laser in the clinic, whilst the evidence for biostimulation is good, makes me wonder how much is the sympathetic touch. Laser therapy coming up with the Khalid laser look?
Hi Kalid; I would like to know if Neuromuscular Electrical Stimulation actually relieve pain? Some people tell me it works great, but it does nothing for me. The only thing that helps relieve my back pain is acupressure. A chiropractor explained to me that my tight muscles are the result of lactic acid build up through pinched nerves. To relieve the pain he would press very hard on the muscle(s) to force out the lactic acid. It seemed to work because I would be completely relieved of pain for a day or so. Is there any scientific basis for either of these treatments? Love your videos. Keep them coming.
Thank you so much Raul! I’ll make sure I can do some videos on things like TENS and NMES in next few weeks!
Love this
🙏🏼🙏🏼 Thank you!
Vey interesting!Cant wait for comments on this . popcorn at the ready!!!lol
😂😂🙏🏼🙏🏼
Nice content
Thank you so much!
Amazing
🙏🏼 glad you enjoyed it!
Hi Khalid, I want to know what's your take with regards to this chiropractic?
Certainty will be coming in future videos!
@@ClinicalPhysio Thanks! Your videos are clinicaly interesting..💕
@@SuperBeetox thank you so much!
Cognitive or real physical benefits, the bottom line is I do feel relief everytime I have..🙂
🙏🏼
You are starting to highlight the mechanism of change, rather than mere statistical analysis. It's more rigorous to ask 'how does X work ' rather than 'does X work (statistically) better than not X'
Thank you!